Which of the following should be a major focus in a teaching plan for a teenager with sickle cell anemia?

A. Eat foods high in iron and vitamin B: Iron is rarely the issue in sickle cell (unlike iron-deficiency anemia), and iron overload is a greater concern. B. Maintain adequate hydration: For teenagers, who are often active or may forget to drink water, emphasizing hydration is the most critical preventative measure to avoid the vaso-occlusion that leads to crisis. C. Limit tobacco use to no more than two cigarettes: Teenagers with sickle cell should not smoke at all; smoking causes vasoconstriction and hypoxia, both of which trigger sickling. D. Maintain environmental temperature at 65° F to 68° F: This is quite cool. Cold temperatures can cause vasoconstriction and trigger a crisis. Patients should stay warm.